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NDC-11 (Package) NDC-9 (Product) (Ascending) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
71205-0797-10 71205-0797 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 3, 2023 In Use
71205-0797-14 71205-0797 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 3, 2023 In Use
71205-0797-20 71205-0797 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 3, 2023 In Use
71205-0797-21 71205-0797 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 3, 2023 In Use
71205-0797-30 71205-0797 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 3, 2023 In Use
71205-0797-60 71205-0797 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 3, 2023 In Use
71205-0797-90 71205-0797 Prednisone Prednisone 20.0 mg/1 Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral May 3, 2023 In Use
71205-0908-00 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-11 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-30 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-55 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-60 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71205-0908-90 71205-0908 LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral July 16, 2021 In Use
71209-0082-01 71209-0082 Raloxifene hydrochloride Raloxifene hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 30, 2017 In Use
71209-0082-05 71209-0082 Raloxifene hydrochloride Raloxifene hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 30, 2017 In Use
71209-0082-11 71209-0082 Raloxifene hydrochloride Raloxifene hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 13, 2021 In Use
71209-0082-13 71209-0082 Raloxifene hydrochloride Raloxifene hydrochloride 60.0 mg/1 Hormonal Therapy Selective Estrogen Receptor Modulator (SERM) Oral Dec. 30, 2017 In Use
71225-0120-01 71225-0120 BENDAMUSTINE HYDROCHLORIDE VIVIMUSTA 25.0 mg/mL Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous Dec. 7, 2022 In Use
71258-0015-02 71258-0015 iobenguane I-131 Azedra 15.0 mCi/mL Chemotherapy Radiopharmaceutical I 131 Intravenous July 30, 2018 In Use
71258-0015-22 71258-0015 iobenguane I-131 Azedra 15.0 mCi/mL Chemotherapy Radiopharmaceutical I 131 Intravenous July 30, 2018 In Use
71287-0119-02 71287-0119 Axicabtagene ciloleucel Yescarta 2000000.0 1/68mL Immunotherapy CAR-T CD19 Intravenous Oct. 18, 2017 In Use
71287-0219-02 71287-0219 brexucabtagene autoleucel TECARTUS 2000000.0 1/68mL Immunotherapy CAR-T CD19 Intravenous July 24, 2020 In Use
71287-0220-02 71287-0220 brexucabtagene autoleucel TECARTUS 1000000.0 1/68mL Immunotherapy CAR-T CD19 Intravenous Oct. 1, 2021 In Use
71288-0100-05 71288-0100 Carboplatin Carboplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous June 19, 2017 In Use
71288-0100-15 71288-0100 Carboplatin Carboplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous June 19, 2017 In Use
71288-0100-45 71288-0100 Carboplatin Carboplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous June 19, 2017 In Use
71288-0100-51 71288-0100 Carboplatin Carboplatin 10.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous June 19, 2017 In Use
71288-0101-10 71288-0101 Oxaliplatin Oxaliplatin 5.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Oct. 1, 2017 In Use
71288-0101-20 71288-0101 Oxaliplatin Oxaliplatin 5.0 mg/mL Chemotherapy Alkylating Agent Platinum Compound Intravenous Oct. 1, 2017 In Use
71288-0104-10 71288-0104 Levoleucovorin calcium Levoleucovorin 50.0 mg/5mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 22, 2019 April 30, 2024 In Use
71288-0105-18 71288-0105 Levoleucovorin calcium Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 16, 2019 In Use
71288-0105-25 71288-0105 Levoleucovorin calcium Levoleucovorin 10.0 mg/mL Ancillary Therapy Chemoprotective Antidote Intravenous Aug. 16, 2019 In Use
71288-0106-10 71288-0106 Bleomycin Sulfate Bleomycin 15.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Aug. 31, 2018 In Use
71288-0107-20 71288-0107 Bleomycin Sulfate Bleomycin 30.0 [USP'U]/1 Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intramuscular, Intrapleural, Intravenous, Subcutaneous Aug. 31, 2018 In Use
71288-0108-06 71288-0108 Cytarabine Cytarabine 20.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Intrathecal, Intravenous, Subcutaneous June 26, 2020 In Use
71288-0109-20 71288-0109 cytarabine Cytarabine 2.0 g/20mL Chemotherapy Antimetabolite Pyrimidine Analog Intrathecal, Intravenous, Subcutaneous July 17, 2018 In Use
71288-0112-90 71288-0112 Melphalan hydrochloride Melphalan hydrochloride Chemotherapy Alkylating Agent Nitrogen Mustard Intravenous June 30, 2019 April 30, 2025 In Use
71288-0113-10 71288-0113 GEMCITABINE HYDROCHLORIDE GEMCITABINE 200.0 mg/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Nov. 1, 2018 In Use
71288-0114-50 71288-0114 GEMCITABINE HYDROCHLORIDE GEMCITABINE 1.0 g/1 Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Nov. 1, 2018 In Use
71288-0115-30 71288-0115 Azacitidine Azacitidine 100.0 mg/30mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous, Subcutaneous Nov. 2, 2020 In Use
71288-0116-11 71288-0116 Busulfan Busulfan 6.0 mg/mL Chemotherapy Alkylating Agent Alkylsulfonate Intravenous Oct. 23, 2020 In Use
71288-0117-06 71288-0117 Gemcitabine hydrochloride Gemcitabine 38.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Dec. 11, 2020 In Use
71288-0117-28 71288-0117 Gemcitabine hydrochloride Gemcitabine 38.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Dec. 11, 2020 In Use
71288-0117-54 71288-0117 Gemcitabine hydrochloride Gemcitabine 38.0 mg/mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous Dec. 11, 2020 In Use
71288-0118-10 71288-0118 Bortezomib Bortezomib 3.5 mg/1 Chemotherapy Proteasome Inhibitor 26S Intravenous, Subcutaneous July 26, 2022 In Use
71288-0119-20 71288-0119 Decitabine Decitabine 50.0 mg/20mL Chemotherapy Antimetabolite Pyrimidine Analog Intravenous July 2, 2021 In Use
71288-0126-90 71288-0126 Carmustine Carmustine Chemotherapy Alkylating Agent Nitrosourea Intravenous Aug. 2, 2021 In Use
71288-0127-15 71288-0127 Topotecan Hydrochloride Topotecan 4.0 mg/15mL Chemotherapy Topoisomerase I Inhibitor Camptothecin Analogs Intravenous Sept. 2, 2019 In Use
71288-0128-20 71288-0128 Clofarabine Clofarabine 1.0 mg/mL Chemotherapy Antimetabolite Purine Analog Intravenous Oct. 23, 2020 In Use
71288-0129-02 71288-0129 Dactinomycin Dactinomycin 0.5 mg/mL Chemotherapy Antitumor Antibiotic Carboxylic Acids and Amino Acids/Peptides Intravenous Nov. 13, 2020 In Use

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